Tsutsumi M, Takase S
Department of Internal medicine, Kanazawa Medical University, Ishikawa, Japan.
Nihon Arukoru Yakubutsu Igakkai Zasshi. 1998 Jun;33(3):171-80.
Although many factors related to the pathogenesis of alcoholic liver disease have been considered, 1) hepatotoxic effects of ethanol and its metabolites, 2) effects of excessive hepatic NADH generation, 3) hypoxia, 4) alterations of the immune system, 5) genetic factors, and 6) nutritional factors may play more important roles to produce alcoholic liver disease. Recently, genetic polymorphism of key enzymes related to metabolism of ethanol and acetaldehyde, alcohol dehydrogenase, cytochrome P4502E1 and aldehyde dehydrogenase, have been discovered. On the other hand, an assay system for hepatitis C virus (HCV) markers has been developed and a high frequency of HCV markers in alcoholics with liver disease has been reported. In this review, we focus on recent gains in our knowledge of pathogenesis of alcoholic liver disease, and discuss the relationship between alcoholic liver disease and HCV, and treatment of alcoholic liver disease.
尽管已经考虑了许多与酒精性肝病发病机制相关的因素,但1)乙醇及其代谢产物的肝毒性作用、2)肝脏中过量烟酰胺腺嘌呤二核苷酸(NADH)生成的影响、3)缺氧、4)免疫系统的改变、5)遗传因素以及6)营养因素在酒精性肝病的发生中可能起更重要的作用。最近,已发现与乙醇和乙醛代谢相关的关键酶,即乙醇脱氢酶、细胞色素P4502E1和乙醛脱氢酶的基因多态性。另一方面,已经开发出丙型肝炎病毒(HCV)标志物的检测系统,并且有报道称肝病酒精患者中HCV标志物的频率较高。在这篇综述中,我们重点关注酒精性肝病发病机制的最新研究进展,并讨论酒精性肝病与HCV之间的关系以及酒精性肝病的治疗。